Causes, incidence, and risk factors
The exact cause of depression is not known. Many researchers believe it is caused by chemical changes in the brain. This may be due to a problem with your genes, or triggered by certain stressful events. More likely, it’s a combination of both. Some types of depression run in families. But depression can also occur if you have no family history of the illness. Anyone can develop depression, even kids.
The following may play a role in depression:
- Alcohol or drug abuse
- Certain medical conditions, including underactive thyroid, cancer, or long-term pain
- Certain medications such as steroids
- Sleeping problems
- Stressful life events, such as:
- Breaking up with a boyfriend or girlfriend
- Failing a class
- Death or illness of someone close to you
- Childhood abuse or neglect
- Job loss
- Social isolation (common in the elderly)
Depression can change or distort the way you see yourself, your life, and those around you.
People who have depression usually see everything with a more negative attitude. They cannot imagine that any problem or situation can be solved in a positive way.
Symptoms of depression can include:
- Agitation, restlessness, and irritability
- Becoming withdrawn or isolated
- Difficulty concentrating
- Dramatic change in appetite, often with weight gain or loss
- Fatigue and lack of energy
- Feelings of hopelessness and helplessness
- Feelings of worthlessness, self-hate, and guilt
- Loss of interest or pleasure in activities that were once enjoyed
- Thoughts of death or suicide
- Trouble sleeping or too much sleeping
Depression can appear as anger and discouragement, rather than feelings of sadness.
If depression is very severe, there may also be psychotic symptoms, such as hallucinations and delusions.
Signs and tests
Your health care provider will ask questions about your medical history and symptoms. Your answers and certain questionnaires can help your doctor diagnose depression and determine how severe it may be.
Blood and urine tests may be done to rule out other medical conditions with symptoms similar to depression.
In general, treatments for depression include:
- Medications called antidepressants
- Talk therapy, called psychotherapy
If you have mild depression, you may only need one of these treatments. People with more severe depression usually need a combination of both treatments. It takes time to feel better, but there are usually day-to-day improvements.
If you are suicidal or extremely depressed and cannot function you may need to be treated in a psychiatric hospital.
MEDICATIONS FOR DEPRESSION
Drugs used to treat depression are called antidepressants. Common types of antidepressants include:
- Selective serotonin re-uptake inhibitors (SSRIs), including fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa), and escitalopram (Lexapro).
- Serotonin norepinephrine reuptake inhibitors (SNRIs), including desvenlafaxine (Pristiq), venlafaxine (Effexor), and duloxetine (Cymbalta).
Other medicines used to treat depression include:
- Tricyclic antidepressants
- Bupropion (Wellbutrin)
- Monoamine oxidase inhibitors
If you have delusions or hallucinations, your doctor may prescribe additional medications.
WARNING: Children, adolescents, and young adults should be watched more closely for suicidal behavior, especially during the first few months after starting medications.
If you do not feel better with antidepressants and talk therapy, you may have treatment-resistant depression. Your doctor will often prescribe higher (but still safe) doses of an antidepressant, or a combination of medications. Lithium (or other mood stabilizers) and thyroid hormone supplements also may be added to help the antidepressants work better.
St. John’s wort is an herb sold without a prescription. It may help some people with mild depression. However, it can change the way other medicines work in your body, including antidepressants and birth control pills. Talk to your doctor before trying this herb.
CHANGES IN MEDICATIONS
Sometimes, medications that you take for another health problem can cause or worsen depression. Talk to your doctor about all the medicines you take. Your doctor may recommend changing your dose or switching to another drug. Never stop taking your medications without first talking to your doctor.
Women being treated for depression who are pregnant or thinking about becoming pregnant should not stop taking antidepressants without first talking to their doctor.
Talk therapy is counseling to talk about your feelings and thoughts, and help you learn how to deal with them.
Types of talk therapy include:
- Cognitive behavioral therapy teaches you how to fight off negative thoughts. You will learn how to become more aware of your symptoms and how to spot things that make your depression worse. You’ll also be taught problem-solving skills.
- Psychotherapy can help you understand the issues that may be behind your thoughts and feelings.
- Joining a support group of people who are sharing problems like yours can also help. Ask your therapist or doctor for a recommendation
Anxiety, worry, and stress are all a part of most people’s life today. But simply experiencing anxiety or stress in and of itself does not mean you need to get professional help or you have an anxiety disorder. In fact, anxiety is a necessary warning signal of a dangerous or difficult situation. Without anxiety, we would have no way of anticipating difficulties ahead and preparing for them.
Anxiety becomes a disorder when the symptoms become chronic and interfere with our daily lives and our ability to function. People suffering from chronic anxiety often report the following symptoms:
- Muscle tension
- Physical weakness
- Poor memory
- Sweaty hands
- Fear or confusion
- Inability to relax
- Constant worry
- Shortness of breath
- Upset stomach
- Poor concentration
These symptoms are severe and upsetting enough to make individuals feel extremely uncomfortable, out of control and helpless.
Fortunately, much progress has been made in the last two decades in the treatment of people with mental illnesses, including anxiety disorders. Although the exact treatment approach depends on the type of disorder, one or a combination of the following therapies may be used for most anxiety disorders:
- Medication : Drugs used to reduce the symptoms of anxiety disorders include anti-depressants and anxiety-reducing drugs.
- Psychotherapy: Psychotherapy (a type of counseling) addresses the emotional response to mental illness. It is a process in which trained mental health professionals help people by talking through strategies for understanding and dealing with their disorder.
- Cognitive-behavioral therapy: People suffering from anxiety disorders often participate in this type of psychotherapy in which the person learns to recognize and change thought patterns and behaviors that lead to troublesome feelings.
- Dietary and lifestyle changes
- Relaxation therapy